Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
Indian J Ophthalmol. 2020 Aug;68(8):1540-1544. doi: 10.4103/ijo.IJO_1673_20.
To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute.
Records of all the patients who presented from March 25 to May 3, 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions.
The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15 to May 3, 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown.
A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.
评估 COVID-19 大流行和全国封锁对一家三级眼科医院患者治疗的影响。
扫描了 2020 年 3 月 25 日至 5 月 3 日期间就诊的所有患者的记录，以评估就诊时的主诉、诊断、建议的治疗和手术干预的详细信息。
与去年同期相比，在封锁期间，门诊就诊次数、视网膜激光治疗、玻璃体内注射和白内障手术分别减少了 96.5%、96.5%、98.7%和 99.7%。根据病史，约有 38.8%的患者可以分诊为非紧急病例，而 59.5%的患者在检查后可以分诊为非紧急病例。只有 84 名患者在 2020 年 4 月 15 日至 5 月 3 日期间选择了视频咨询。有 9 名患者因穿孔性角膜溃疡就诊，但由于供体角膜组织缺乏，无法进行穿透性角膜移植术。其中一名患者因病情进展不得不进行眼球摘除。两名因外伤就诊的开放性眼球损伤患者在受伤后就诊较晚，不得不进行眼球摘除。由于封锁期间与后勤相关的问题，约有 9%的患者无法进行建议的紧急手术。
在封锁期间，相当数量的患者无法获得足够的治疗。医院需要建立能力，以满足 COVID-19 时代后预期的患者激增，特别是那些需要立即亲自就诊的患者。大量患者可以归类为非紧急病例。这些患者需要通过视频咨询来进行随访，以便为高危患者留出足够的亲自就诊时间。
